CDI Quality Audits for Queries

The first question on our CDI Quality Audit (for queries) is "Was the query necessary/ required?". This is followed by six more questions regarding how well was the query constructed. Total 7 questions = 7 points for each query audited. If the CDI fails the first question i.e. if the query was not required (unwanted/ non-impacting query/ irrelevant), they lose all 7 points i.e. the next 6 questions about the "quality of the query" are void. So the CDI loses all 7 points for that query audit.

Here's my question: What do y'all think about this? Should we consider reviewing the query anyways for the next 6 points? If they wrote a good (unwanted/ non-impacting) query, should they earn some points for their effort to write a good query? 

Just trying to get an opinion on the process - whether the CDI should lose all 7 points for an unwanted query, or be considered for some points if the query was well written despite being non-impacting OR irrelevant. 

Thanks in advance. 


  • Depends upon what precisely is meant by ‘query not needed”?  Does that mean the condition subject of query was already documented when the query was written such that no query was required?

    I ask because you use the term ‘non-impact’ query - I sometimes will write a ‘non-impact’ query solely for educational purposes...particularly if the query is directed to a Hospitalist given they are the Attending on most of our cases.  We also have a Residency Program, and they use a lot of terms that may not be very precise, such as ‘acute on chronic renal disease’.   A coding N17.9 or N18.4 may not impact that particular encounter, but very often will impact some other encounter.

    I also feel writing queries that may not impact DRG support the integrity of a program and demonstrates CDI does not ‘only’ issue a query if we expect a positive financial impact.

    Hope this ‘makes sense’?

    Paul Evans, RHIA, CCDS
  • We use a 100 point score for the audits that includes a certain number of points for various aspects of the review and the query. They can get full points, half points, or no points. Even if the query wasn't necessarily warranted, we will still review the other elements of the query (was it compliant/leading, relevant options, why wasn't it warranted, etc.) for educational purposes, and they still get points for the rest of the review (i.e. correct PDx, correct SDx, correct DRG, findings are there and relevant, follow up scheduled and completed in a timely manner, etc.).

  • We use a 'fail' if the query is non-compliant for any reason.
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